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Using AI to negotiate a $195k hospital bill down to $33k

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Re: Using AI to negotiate a $195k hospital bill down to $33k

#261

Post by [deleted] »

Workaccount2 wrote: post #177
lifeisstillgood wrote: post #108

The rest of the western world just looks at this as wonders why Americans put up with this. Using the latest in technology to move an a bill from existential to merely crippling

Because 92% of Americans have health insurance, and 22% have totally free everything covered health insurance. Of the uninsured, most either are eligible but don't apply, have insurance through work but forgo it, or are not US citizens. All said and done, you end up with a very small sliver of people who are legitimately uninsured, which means the problem mostly exists as scary stories rather than people actually exp…

[deleted]

Re: Using AI to negotiate a $195k hospital bill down to $33k

#262

Post by zarmsdos »

egorfine wrote: post #253
chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

[flagged]

Decades of right-wing propaganda, unfortunately. They tend to have an emotional reaction against any sort of socialized anything, including healthcare.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#263

Post by fsckboy »

pbhjpbhj wrote: post #138
ecosystem wrote: post #74

The American Medical Association owns copyright to all the codes and their descriptions. They have an extremely restrictive and expensive licensing options and they strictly forbid training models with the codes. This month, the practice was called out ( https://www.help.senate.gov/rep/newsroom/press/chair-cassidy... ) so the Overton window may be opening. The AMA (a nonprofit!) clears ~$300M/year revenue from the co…

A code is not an artistic expression and so can't be copyrightable. The layout of a book of codes, for sure, but the information in it... might be protectable with other IPR but not copyright. Does not stop people threatening you though. This is my opinion only, not legal advice, and does not relate to my employment.

>A code is not an artistic expression and so can't be copyrightable.

that was changed

https://www.bitlaw.com/copyright/database.html

Databases are generally protected by copyright law as compilations. Under the Copyright Act, a compilation is defined as a "collection and assembling of preexisting materials or of data that are selected in such a way that the resulting work as a whole constitutes an original work of authorship." 17. U.S.C. § 101. The preexisting materials or data may be protected by copyright, or may be unprotectable facts or ideas (see the BitLaw discussion on unprotected ideas for more information).

(I did not use AI, but this appeared at the top of my search and I think the search engine used AI to generate it):

In the European Union, databases are protected under the Database Directive, which provides legal protection based on the originality of the selection or arrangement of their contents...Some countries offer additional protections for databases that do not meet the originality requirement, often through sui generis rights.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#264

Post by themafia »

aeturnum wrote: post #8

It seems like the AIs role was in applying lengthy and complex medicare billing rules - it did not do negotiating and it doesn't seem like the accuracy of its understanding of medicare practices was actually checked. The author reasonably accused the hospital of gouging and the hospital came back with a much lower offer. I'd be interested to hear from a charge coding expert about Claude's analysis here and if it was…

> the hospital came back with a much lower offer.

Yes, because, there is an entire department _dedicated_ to this function. You just call them and say "I can't pay this" and you'll get the same result.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#265

Post by aeturnum »

CGMthrowaway wrote: post #91
aeturnum wrote: post #8

It seems like the AIs role was in applying lengthy and complex medicare billing rules - it did not do negotiating and it doesn't seem like the accuracy of its understanding of medicare practices was actually checked. The author reasonably accused the hospital of gouging and the hospital came back with a much lower offer. I'd be interested to hear from a charge coding expert about Claude's analysis here and if it was…

>It seems like the AIs role was in applying lengthy and complex medicare billing rules - it did not do negotiating and it doesn't seem like the accuracy of its understanding of medicare practices was actually checked. The author reasonably accused the hospital of gouging and the hospital came back with a much lower offer. What exactly do you think negotiating is? Real negotiation in business transactions is more ofte…

I guess I would think that negotiating at least involves communicating with your counter-party. Its role here feels more similar to being a billing consultant. There are plenty of people (and systems) that pass messaging over to the actual AI - which was my expectation from the title and why I noted it didn't happen.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#266

Post by timeon »

Capricorn2481 wrote: post #238
Workaccount2 wrote: post #177

Earlier quoted context omitted.

Because 92% of Americans have health insurance, and 22% have totally free everything covered health insurance. Of the uninsured, most either are eligible but don't apply, have insurance through work but forgo it, or are not US citizens. All said and done, you end up with a very small sliver of people who are legitimately uninsured, which means the problem mostly exists as scary stories rather than people actually exp…

Wildly false. This thread is full of people sharing stories of being supposedly "insured" and getting fucked anyway. The complete lack of transparency around what your insurance covers, something you can't be expected to verify while in the middle of a dire medical crisis, can lead to a life destroying bill. Nobody should have to be wondering what company an ambulance works for. It's crazy. The whole world thinks it'…

> Nobody should have to be wondering what company an ambulance works for.

Is this real?!

Re: Using AI to negotiate a $195k hospital bill down to $33k

#267

Post by zzzeek »

egorfine wrote: post #253
chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

[flagged]

not sure why you're getting downmodded. People will say M4A ("medicare for all") polls at super high levels, and they're right, it does. But poll those same people telling them "would you favor that your employer-based healthcare would be rescinded and you would instead get healthcare from a new government controlled plan, where there would be no other options", which is the assumption M4A's viability is based on, and that poll turns right upside down.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#268

Post by lotsofpulp »

chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

I was under the impression that if you were to go to an emergency room, life saving surgery would be scheduled regardless of who is paying (or not paying), due to EMTALA. I can't imagine a hospital waiting for an insurance company's approval to pay for a procedure to schedule a child's life saving surgery.

Is this incorrect?

Re: Using AI to negotiate a $195k hospital bill down to $33k

#269

Post by antisthenes »

BurningFrog wrote: post #189
ecosystem wrote: post #74

The American Medical Association owns copyright to all the codes and their descriptions. They have an extremely restrictive and expensive licensing options and they strictly forbid training models with the codes. This month, the practice was called out ( https://www.help.senate.gov/rep/newsroom/press/chair-cassidy... ) so the Overton window may be opening. The AMA (a nonprofit!) clears ~$300M/year revenue from the co…

It's important to understand that a "nonprofit" can be just as greedy as any other organization. It can't pay out profits to shareholders, but it can hire its owners as employees and pay them any number of millions.

Any non-profit can always claim to inflate their expenditures up to (and above) their expenses and pay lavish bonuses to their employees, like you said.

Doesn't change what it basically is - aka Scamming the Public, and privatising the gains.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#270

Post by whimsicalism »

mrguyorama wrote: post #249
wbronitsky wrote: post #127

Earlier quoted context omitted.

Matt Stoller, a journalist who blogs about monopolies, just wrote all about the pricing issue this week: https://www.thebignewsletter.com/p/monopoly-round-up-obamaca... America has doubled down on middlemen controlling the prices of medical care and making sure that there is no set price for anything. With the ACA effectively falling apart in the new budget, we do have a chance to move to a different reality, one whe…

> one where medicare prices are the set prices for everything, but that is nearly a political impossibility given the amount that these middlemen spend in keeping politicians who support that from winning primaries. You're missing the part where the Stated and objective goal of popular politicians from one party is not to let that happen. They don't get elected because someone scheming to control their funding (thoug…

i don't really disagree with you, but i do think it is funny given that the single largest policy targeting medical price transparency came from a republican admin.

i'm potentially on board with signing up everyone for medicare, but only if we actually can get voters to vote for the taxes necessary to fund that. i doubt we will be able to given we can't get voters to vote for the taxes necessary to fund existing medicare consumption.

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